Elisabeth Heath, MD, FACP, discusses genitourinary cancers, including which cancers are included under this umbrella, symptoms of the disease, risk factors, and advancements in treatment.
In the episode, Dr. Heath covers the following questions:
1) Your area of expertise is genitourinary cancer. What does that mean? Is your expertise specific to men or women, or do you treat all patients?
2) As an oncologist focusing in genitourinary cancer, prostate cancer, kidney cancer and bladder cancer are probably among the most frequent types of cancer you treat. Is that true?
3) Prostate cancer is the most commonly diagnosed cancer in men. What causes prostate cancer? Who’s most at risk for prostate cancer and what signs and symptoms should men be aware of?
4) According to the American Cancer Society, there are about 80,000 cases of bladder cancer diagnosed each year. What causes the disease and what are the symptoms? Are certain people more likely to be diagnosed with the disease?
5) Kidney cancer is less common than bladder cancer. Talk about the causes and symptoms of this disease, as well as the risk factors.
6) There have been many advancements in cancer treatment in recent years. Can you talk about these advancements, especially those treatments that are the most promising in the treatment of prostate cancer and bladder cancer?
7) What advice do you have for listeners who have a family history of these types of cancers?
Selected Podcast
Oncology: Genitourinary Cancer
Featuring:
Learn more about Elisabeth Heath, MD
Elisabeth Heath, MD
Elisabeth Heath, MD, is the Leader of the Genitourinary Multidisciplinary Team at Karmanos Cancer Institute.Learn more about Elisabeth Heath, MD
Transcription:
Michael Carrese (Host): Genitourinary cancer is a term you might not be familiar with, but the disease it includes you most certainly are including prostate cancer, kidney, and bladder cancer as well. We’re going to learn all about this branch of cancer medicine today from Dr. Elisabeth Heath, leader of the genitourinary multidisciplinary team at Karmanos Cancer Institute. This is McLaren’s In Good Health. I'm Michael Carrese. Dr. Heath, why don’t you start with an overview of genitourinary cancer and tell us if your expertise is specific to men or women or do you treat all patients?
Elisabeth Heath, MD, FACP (Guest): I do treat all patients. Genitourinary cancer is a mouthful, but it really is highlighted best by three well known cancers. One is prostate cancer, another is kidney cancer, and the third would be bladder cancer.
Host: In men, prostate is probably the most common, right?
Dr. Heath: It is. These numbers are unfortunately not going away. As it effects half of our society, it’s definitely a cancer we need to pay attention to.
Host: What causes prostate cancer? Another way to put it is why is the prostate so susceptible to cancer?
Dr. Heath: That’s a great question. I’ll tell you. If I find out that answer I think I’ll be retired and collecting my Nobel prize. There's so much research over the many decades that have tried to figure out why prostate cancer occurs. For a small walnut sized organ that exists in men, it certainly can be quite troublesome. The message isn’t all dire. It’s not that every man with prostate cancer gets in trouble. It’s just a very common cancer in men but can be cured if found early. So there is a need to make sure that the awareness about prostate cancer is there.
Host: Right. That’s why screening always comes up as such an important thing because if you catch it early, there are some pretty good treatments out there.
Dr. Heath: It is. Recently what’s also challenging is that the screening message, perhaps, is not as straight forward that one hopes that it would be. That’s a little bit challenging where it sort of made the landscape of really understanding screening very complicated.
Host: Right. It probably goes back a decade now, I think, when the federal panel came out and sort of adjusted what they thought was necessary in terms of the frequency of screening and when it starts. So why don’t you give us what you believe to best the best arrangement for screening for men?
Dr. Heath: Yes. You know there's many, many guidelines but I think as a national cancer institute designated comprehensive cancer center we certainly partner very closely with many societies, one of them being the American Cancer Society. So we tend to adopt specific guidelines consistent with the American Cancer Society. We really do believe that a discussion at least with your doctor should take place when you're at 50 for men who are at average risk and those who are expected to live more than 10 years. Then there's a special group where there's a little bit of a higher risk of developing prostate cancer. In those men we really think a discussion about screening should occur around age of 45. In this group for high risk of getting prostate cancer are men who are African-Americans or those with a first degree relative like a father or a brother that’s been diagnosed with prostate cancer at an age that’s earlier than 65. So young upon diagnosis. Then when you're 40 or younger at the really high risk group, which is more than one first degree relative who have had prostate cancer at an early age such as two brothers or a father and a brother then we really think earlier screening is better.
Host: We’re talking to Dr. Elisabeth Heath. She’s the leader of the genitourinary multidisciplinary team at Karmanos Cancer Institute doing an overview of genitourinary cancer. Why don’t we move on to bladder cancer? About 80,000 cases of that diagnosed in the U.S. each year. What's the main cause of that and what symptoms should people be on the lookout for?
Dr. Heath: Right. Now bladder cancer is a cancer that can effect men and women. So I think it’s a little important to know that some of the earlier signs might be seeing blood in the urine. Sometimes it’s visible to the eye. Sometimes it’s you going to the doctor and that doctor checking your urine and saying, “Hm, maybe there's some signs of blood that can't be seen by the human eye, but the tests certainly pick it up. That might be a bit worrisome.” Then there are other changes in your bladder habits like urinating more than usual or there’s some pain or burning upon urination. Those are signs that should get you to the doctor’s office for a discussion and/or a test. Then some of the symptoms of advanced bladder cancer might be having some weight loss or tiredness or pain in the back. Maybe even some swelling in the feet or bone pain. So they're a little bit vague, but I think coupled with some of the urinary symptoms we really do worry that we don’t catch bladder cancer as early as we can. So we encourage those with any kinds of those symptoms to please seek medical assistance.
Host: What are the most common treatments for bladder cancer and how’s the survival rate these days?
Dr. Heath: Again, if it’s caught early and the bladder cancer is not deep into the wall of the bladder, it’s a highly curable cancer. Most of the time it’s under the care of the urologist and patients do well. I think as an oncologist we tend to see patients who have already advanced or metastatic or spread disease. Those folks tend to have more difficult time to overcome it. Like in any other part of cancers when it’s already a metastatic or a stage four upon diagnosis it’s very difficult to cure. Our challenge would be to provide the treatment that could help you feel better and hopefully help you live longer, but there are treatment options available.
Host: So moving on to kidney cancer, less common than bladder cancer but obviously still a problem. Give us an overview of that.
Dr. Heath: Yeah. Kidney cancer is—interesting is the wrong word, but it’s a very different type of cancer because we tend to think about kidney cancer as a cancer that has a very immune type of origin perhaps. So we understand how the cancer sort of progressed into the kidney. We do understand that. We don’t really understand why both men and women get it and why some patients do better than others. So there are lots of research that’s going on in this field as well. We always like to make a distinction that there are two parts of the kidney. When we talk about kidney cancer or sometimes we call it renal cell carcinoma, that’s usually on the outer part of the kidney. On the inner part of the kidney we call that a renal pelvis cancer. They tend to be treated like bladder cancer. So I make that distinction because sometimes when we share information with our neighbors or our family we tend to just lump everything together. The treatment for kidney cancer is very different than the treatment for bladder or we also call that urothelial cancer.
Host: Boy cancer’s complicated, right.
Dr. Heath: Cancer is complicated. I think I always advocate for every patient to really understand what the diagnosis is, what the stage of the cancer is, and what is the treatment plan for the journey. So not just what are you doing today or a month from then but what’s the overall big picture? Are we thinking there’s chemotherapy? Are we thinking there's clinical trials? When you have that kind of more comprehensive discussion with your doctor I think it helps everybody. Not just the patient or the doctor but the family and the community.
Host: So as we head toward the end of the program here, let’s end on a more positive train of thought. There have been a lot of advancements in cancer treatment in recent years. There was recent news that the death rates are going down. In terms of prostate and bladder cancer, what are the promising treatments out there?
Dr. Heath: Well prostate cancer, unfortunately that’s the one cancer where the death rate has not gone down. In the other cancers that is certainly true. The advancements in prostate cancer just continue to grow. I think there is hope really in all three cancers. We’re looking at newer imaging studies to try find the cancer earlier. We’re looking at new medications that can kind of single out those prostate cells that have gone to different places and tried to get them and kill them so that you can live longer. Just lots of new exciting advancements. With bladder cancer, the treatments there have really changed in just the last couple of years. We used to only have chemotherapy for advanced cancer. Now there's immunotherapy. There are new drugs that target a specific part of a cancer cell. There are new drugs that target a specific genetic mutation that a bladder cancer patient might have. So we have gone from just chemotherapy, which has been the same drugs for over 100 years, and now we’re in a new era.
Host: So the word to get out there folks is that a lot can be done these days, but it’s really important that it’s caught early. That means getting regular checkups and being really aware of the signs and symptoms. We’ve been talking to Dr. Elisabeth Heath. She’s the leader of the genitourinary cancer multidisciplinary team at Karmanos Cancer Institute. If you want to learn more about Dr. Heath or submit a question, you can visit mclaren.org/heath. Thanks very much for being with us today.
Dr. Heath: Thanks for having me.
Host: If you found this podcast helpful, please share it on your social channels or check out the full podcast library for additional topics that may interest you. This is McLaren’s In Good Health. Thanks for listening.
Michael Carrese (Host): Genitourinary cancer is a term you might not be familiar with, but the disease it includes you most certainly are including prostate cancer, kidney, and bladder cancer as well. We’re going to learn all about this branch of cancer medicine today from Dr. Elisabeth Heath, leader of the genitourinary multidisciplinary team at Karmanos Cancer Institute. This is McLaren’s In Good Health. I'm Michael Carrese. Dr. Heath, why don’t you start with an overview of genitourinary cancer and tell us if your expertise is specific to men or women or do you treat all patients?
Elisabeth Heath, MD, FACP (Guest): I do treat all patients. Genitourinary cancer is a mouthful, but it really is highlighted best by three well known cancers. One is prostate cancer, another is kidney cancer, and the third would be bladder cancer.
Host: In men, prostate is probably the most common, right?
Dr. Heath: It is. These numbers are unfortunately not going away. As it effects half of our society, it’s definitely a cancer we need to pay attention to.
Host: What causes prostate cancer? Another way to put it is why is the prostate so susceptible to cancer?
Dr. Heath: That’s a great question. I’ll tell you. If I find out that answer I think I’ll be retired and collecting my Nobel prize. There's so much research over the many decades that have tried to figure out why prostate cancer occurs. For a small walnut sized organ that exists in men, it certainly can be quite troublesome. The message isn’t all dire. It’s not that every man with prostate cancer gets in trouble. It’s just a very common cancer in men but can be cured if found early. So there is a need to make sure that the awareness about prostate cancer is there.
Host: Right. That’s why screening always comes up as such an important thing because if you catch it early, there are some pretty good treatments out there.
Dr. Heath: It is. Recently what’s also challenging is that the screening message, perhaps, is not as straight forward that one hopes that it would be. That’s a little bit challenging where it sort of made the landscape of really understanding screening very complicated.
Host: Right. It probably goes back a decade now, I think, when the federal panel came out and sort of adjusted what they thought was necessary in terms of the frequency of screening and when it starts. So why don’t you give us what you believe to best the best arrangement for screening for men?
Dr. Heath: Yes. You know there's many, many guidelines but I think as a national cancer institute designated comprehensive cancer center we certainly partner very closely with many societies, one of them being the American Cancer Society. So we tend to adopt specific guidelines consistent with the American Cancer Society. We really do believe that a discussion at least with your doctor should take place when you're at 50 for men who are at average risk and those who are expected to live more than 10 years. Then there's a special group where there's a little bit of a higher risk of developing prostate cancer. In those men we really think a discussion about screening should occur around age of 45. In this group for high risk of getting prostate cancer are men who are African-Americans or those with a first degree relative like a father or a brother that’s been diagnosed with prostate cancer at an age that’s earlier than 65. So young upon diagnosis. Then when you're 40 or younger at the really high risk group, which is more than one first degree relative who have had prostate cancer at an early age such as two brothers or a father and a brother then we really think earlier screening is better.
Host: We’re talking to Dr. Elisabeth Heath. She’s the leader of the genitourinary multidisciplinary team at Karmanos Cancer Institute doing an overview of genitourinary cancer. Why don’t we move on to bladder cancer? About 80,000 cases of that diagnosed in the U.S. each year. What's the main cause of that and what symptoms should people be on the lookout for?
Dr. Heath: Right. Now bladder cancer is a cancer that can effect men and women. So I think it’s a little important to know that some of the earlier signs might be seeing blood in the urine. Sometimes it’s visible to the eye. Sometimes it’s you going to the doctor and that doctor checking your urine and saying, “Hm, maybe there's some signs of blood that can't be seen by the human eye, but the tests certainly pick it up. That might be a bit worrisome.” Then there are other changes in your bladder habits like urinating more than usual or there’s some pain or burning upon urination. Those are signs that should get you to the doctor’s office for a discussion and/or a test. Then some of the symptoms of advanced bladder cancer might be having some weight loss or tiredness or pain in the back. Maybe even some swelling in the feet or bone pain. So they're a little bit vague, but I think coupled with some of the urinary symptoms we really do worry that we don’t catch bladder cancer as early as we can. So we encourage those with any kinds of those symptoms to please seek medical assistance.
Host: What are the most common treatments for bladder cancer and how’s the survival rate these days?
Dr. Heath: Again, if it’s caught early and the bladder cancer is not deep into the wall of the bladder, it’s a highly curable cancer. Most of the time it’s under the care of the urologist and patients do well. I think as an oncologist we tend to see patients who have already advanced or metastatic or spread disease. Those folks tend to have more difficult time to overcome it. Like in any other part of cancers when it’s already a metastatic or a stage four upon diagnosis it’s very difficult to cure. Our challenge would be to provide the treatment that could help you feel better and hopefully help you live longer, but there are treatment options available.
Host: So moving on to kidney cancer, less common than bladder cancer but obviously still a problem. Give us an overview of that.
Dr. Heath: Yeah. Kidney cancer is—interesting is the wrong word, but it’s a very different type of cancer because we tend to think about kidney cancer as a cancer that has a very immune type of origin perhaps. So we understand how the cancer sort of progressed into the kidney. We do understand that. We don’t really understand why both men and women get it and why some patients do better than others. So there are lots of research that’s going on in this field as well. We always like to make a distinction that there are two parts of the kidney. When we talk about kidney cancer or sometimes we call it renal cell carcinoma, that’s usually on the outer part of the kidney. On the inner part of the kidney we call that a renal pelvis cancer. They tend to be treated like bladder cancer. So I make that distinction because sometimes when we share information with our neighbors or our family we tend to just lump everything together. The treatment for kidney cancer is very different than the treatment for bladder or we also call that urothelial cancer.
Host: Boy cancer’s complicated, right.
Dr. Heath: Cancer is complicated. I think I always advocate for every patient to really understand what the diagnosis is, what the stage of the cancer is, and what is the treatment plan for the journey. So not just what are you doing today or a month from then but what’s the overall big picture? Are we thinking there’s chemotherapy? Are we thinking there's clinical trials? When you have that kind of more comprehensive discussion with your doctor I think it helps everybody. Not just the patient or the doctor but the family and the community.
Host: So as we head toward the end of the program here, let’s end on a more positive train of thought. There have been a lot of advancements in cancer treatment in recent years. There was recent news that the death rates are going down. In terms of prostate and bladder cancer, what are the promising treatments out there?
Dr. Heath: Well prostate cancer, unfortunately that’s the one cancer where the death rate has not gone down. In the other cancers that is certainly true. The advancements in prostate cancer just continue to grow. I think there is hope really in all three cancers. We’re looking at newer imaging studies to try find the cancer earlier. We’re looking at new medications that can kind of single out those prostate cells that have gone to different places and tried to get them and kill them so that you can live longer. Just lots of new exciting advancements. With bladder cancer, the treatments there have really changed in just the last couple of years. We used to only have chemotherapy for advanced cancer. Now there's immunotherapy. There are new drugs that target a specific part of a cancer cell. There are new drugs that target a specific genetic mutation that a bladder cancer patient might have. So we have gone from just chemotherapy, which has been the same drugs for over 100 years, and now we’re in a new era.
Host: So the word to get out there folks is that a lot can be done these days, but it’s really important that it’s caught early. That means getting regular checkups and being really aware of the signs and symptoms. We’ve been talking to Dr. Elisabeth Heath. She’s the leader of the genitourinary cancer multidisciplinary team at Karmanos Cancer Institute. If you want to learn more about Dr. Heath or submit a question, you can visit mclaren.org/heath. Thanks very much for being with us today.
Dr. Heath: Thanks for having me.
Host: If you found this podcast helpful, please share it on your social channels or check out the full podcast library for additional topics that may interest you. This is McLaren’s In Good Health. Thanks for listening.